Physician Advisory Committees

September 29, 2015

Allowing Physicians to Take the Reins of Leadership and Shape the Future of Healthcare As the soldiers on the ground and in the patient rooms, physicians can best discover and discard healthcare waste while simultaneously implementing programs to improve patient care. While many remain comfortable only in the patient...

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Physician Behavior Pattern Detection for Fraud, Abuse, and Waste in Healthcare

September 22, 2015

A Predictive Intelligence Approach to Lowering Healthcare Costs In 2011, The National Healthcare Anti-Fraud Association (NHCAA) estimated an average of 3 percent to 10 percent of healthcare spending is lost because of fraud – which includes non-rendered services, upcoding, unbundling, mischaracterization, unnecessary medical services and kickbacks.1 That’s up to $230...

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A Cost-Saving, Physician-Friendly Alternative for Prior Authorization

September 15, 2015

Improving Outcomes and Reducing Costs with a Non-Denial Model Requiring prior authorization for medical diagnostic testing and procedures provides one of the only captive periods when a physician can be engaged with the payer and its utilization management services to determine the most appropriate, evidence-based care that their patients...

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